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Br J Dermatol. 2016 Oct;175(4):735-43. doi: 10.1111/bjd.14567. Epub 2016 Jul 6.

Low- and high-risk human papillomavirus genotype infections in intra-anal warts in HIV-positive men who have sex with men.

Author information

1
Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands. m.l.vanheukelom@amc.uva.nl.
2
Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands. m.l.vanheukelom@amc.uva.nl.
3
Department of Dermatology, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands. m.l.vanheukelom@amc.uva.nl.
4
Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.
5
Center for Infection and Immunology Amsterdam (CINIMA), Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.
6
Department of Dermatology, Academic Medical Center, 1105AZ, Amsterdam, the Netherlands.
7
STI Outpatient Clinic, Public Health Service of Amsterdam (GGD Amsterdam), 1018 WT, Amsterdam, the Netherlands.
8
DDL Diagnostic Laboratory, 2288 ER, Rijswijk, the Netherlands.
9
Department of Pathology, Weill Medical College of Cornell University, New York, NY, 10065, U.S.A.
10
Department of Dermatology, The Leiden University Medical Center, 2300 RC, Leiden, the Netherlands.
11
Department of Dermatology, Roosevelt Clinics, 2321 BL, Leiden, the Netherlands.

Abstract

BACKGROUND:

Anogenital warts are often presumed to represent nondysplastic or low-grade anal intraepithelial neoplasia (LGAIN). We previously demonstrated that up to 20% of intra-anal warts in HIV-positive men who have sex with men (MSM) contain regions of high-grade AIN (HGAIN).

OBJECTIVES:

To determine the causative human papillomavirus (HPV) types of low- and high- grade dysplastic areas in warts from HIV-positive MSM.

METHODS:

A total of 42 intra-anal warts from 41 HIV-positive MSM were graded as nondysplastic, LGAIN or HGAIN. Whole-tissue sections (WTS) were analysed with the SPF10 polymerase chain reaction/LiPA25 HPV genotyping system. If the WTS contained multiple HPV types, dysplastic regions were isolated by laser capture microdissection (LCM) for HPV genotyping.

RESULTS:

Overall, 38 of 42 (91%) WTS tested positive for HPV DNA. Of these, 23 (61%) contained a single HPV type and 15 (39%) contained multiple HPV types. All LCM-selected regions contained no more than one HPV type. Ten of 42 (24%) WTS contained HGAIN disease, of which six (60%) were associated with a high-risk HPV (hrHPV) genotype. Twenty-three of 42 WTS contained LGAIN disease, of which two (9%) were associated with hrHPV. AIN lesions containing hrHPV types were identified using p16 staining.

CONCLUSIONS:

LGAIN lesions can be caused by high-risk HPV genotypes and vice versa. We therefore recommend routine follow-up and treatment of all dysplastic intra-anal warts for HIV-positive MSM.

PMID:
26994411
DOI:
10.1111/bjd.14567
[Indexed for MEDLINE]

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